Liver disease is one of the most important health problem in Thailand.Incidence of viral hepatitis,such as chronic hepatitis B and C are decreased because of primary prevention and better treatment options.Nonalcoholic fatty liver disease (NAFLD)is now a leading cause of liver disease in the new millennium especially in diabetic patients.There were studies on prevalence of NAFLD in diabetes in many countries but the actual prevalence in diabetic Thai patients is still unknown.
The aims of the present study are (1)prevalence of liver disease in type 2 diabetes mellitus with transaminitis at outpatient clinic,Rajvithi hospital and (2)clinical characteristics of diabetic patients with biopsy proven nonalcoholic steatohepatitis (NASH).
Data collected from 391 type II diabetic patients at outpatient diabetic clinic,Rajvithi hospi-tal. Baseline patient characteristic profile,laboratory chemistry values and liver histology were obtained for analyses on prevalence of liver disease and clinical characteristics of diabetic patients with NASH. Data were analyzed using student t-test for continuous variables and Chi-square test for categorical variables.P-value <0.05 was considered significance.
Transaminitis in type II diabetic patients was found to be only 3.1%and the most common etiology was NASH.Clinical characteristics of NASH compared with the control group were demonstrated difference in statistically significant in only four variables including mean age (53.4 ±7.8 vs 62.2 ±11.1 years),diabetic complications (0 vs.31%),alcohol drinking (0 vs 10%)and fasting blood sugar (200.9 ±42.0 vs.150.7 ±48.5), respectively.The other variables (BMI,gender,WHR,duration of diabetes,co morbid disease and lipid profile) were not significantly different.Seven of ten patients with NASH who were proved by a liver biopsy revealed a moderate to severe degree of necroinflammatory activity and fibrotic stage 2 and 3.
Our findings indicated that NASH was the most common liver disease in type II diabetic patients with transaminitis,in outpatient DM clinic,Rajvithi hospital.The significant risk factors of NASH were associated with age,diabetic complications,alcohol drinking and fasting blood sugar.Additionally,most of liver histologic studies showed moderate to severe necroinflammatory activities and fibrotic stage 2 and 3,indicating a high risk for severe disease.
[Thai J Gastroenterol 2008;9(1):19-24.]